Injury Analysis: Week 5 Injury Updates

Santonio Holmes
There's a cloud of mystery surrounding the injury to the Jets receiver but let's do our best to look at the facts. We know Holmes suffered a non-contact injury in New York's loss to San Francisco. The injury was bad enough that Holmes gave himself up and fumbled the ball on the play and he was eventually carted off the field. Initial reports suggested the injury occurred to his knee but the Jets have now ruled it a left foot injury. X-rays were negative, ruling out a significant fracture, and doctors have also ruled out an Achilles tendon injury. However, the team is floating Holmes' MRI results around amongst specialist in order to determine the exact nature and severity of the injury.

The specialists will likely focus on the midfoot, an area formed where the metatarsal bones of the foot meet with four very specific bones known as the cuboid and the three cuneiforms. Here five joints are formed and stabilized by numerous ligaments, none more important than Lisfranc's ligament. The Lisfranc ligament is located at the base of the second metatarsal and like any other ligament can be sprained. The initial way to treat a significant Lisfranc injury was amputation but fortunately for Holmes we no longer live in the 1800's. In today's medical environement a Lisfranc sprain is treated with immobilization or in some cases surgery.

Holmes' MRI will also be examined for any muscular injuries. The bottom or plantar aspect of the foot is divided into four layers of muscles. These muscles are responsible for foot and toe movement and are vital for walking and running. A rupture or tear of any one of these multiple muscles located here would be severely limiting for a receiver.

Regardless of the specifics surrounding the injury, it isn't looking good for Holmes' availability over the next few weeks. Fantasy owners would be wise to start the search for a suitable backup. The best bet for fantasy owners won't be in New York as injuries continue to limit Stephen Hill and tight end Dustin Keller.

Greg Jennings
The Packers could be without Jennings for a week or two as the Pro Bowler was forced to leave the team's win over the Saints after he aggravated his previously strained groin. A serious red flag is raised in my mind any time a receiver has a reoccurring muscular injury in a lower extremity. The alarm, whether it is with the groin, hamstring, or quadriceps, is one based purely on biomechanics. Muscles, particularly those in the core and legs, are an interconnected arrangement of parts working in unison to carry out a desired action. If an injury occurs somewhere along the sequence, the other parts are directly and indirectly affected.

For example, imagine the leg as an iron chain, where each of the muscle groups (hamstring, quad, groin) serves as a link in the chain. If one of these links is weakened or not functioning correctly, the strength and ability of the entire chain is compromised as the other links undergo a compensational shift to makeup for the change. Even the slightest of shifts can have a negative effect, leading to muscle pain, limitation, and an increase in the player's inherent risk of suffering another injury.

Jennings reinjured the area, suggesting it was not completely healed. He will press the reset button on his rehab and start over in the recovery process. Since the first injury kept him out one week, I suspect the Packers medical staff will proceed with extreme caution and sit Jennings for Week 5 and possibly Week 6. If he does play, he remains an extremely risky play, as the groin will be especially susceptible to reinjury.

Hakeem Nicks
Continuing with our theme of injured receivers, Nicks continues to experience swelling and pain in his knee despite sitting out Week 3. The injury occurred when he fell in Week 2, injuring the knee and irritating his surgically repaired foot. He has not shown any signs of improvement and Tom Coughlin would not speculate on his availability for this week against the Browns.

Unfortunately this is another example of an injury that could cascade and cause problems indirectly on another area. If the foot is causing him pain and forcing him to alter his gait, it could cause issues with the now injured knee and vice versa. He has to get the knee inflammation in control but that will be hard to gauge since the foot has already limited his involvement in practice. A decision on Nicks won't likely come until late in the week so keep a close eye on reports out of New York.

Turf Burns

Matt Forte: Forte looked ok in his Monday night return, particularly after having the ankle retaped. How the ankle responds in the next few days will be key but Forte should be available against the Jaguars. The Bears will slowly incorporate Forte back into action, employing Michael Bush as needed.

Jake Locker: Expect Locker to miss Week 5 recovering from his second shoulder ailment of the early season. The reports are mixed as to what actually happened. The injury has been called a separated shoulder and a dislocated shoulder, two different injuries. A dislocation means the glenohumeral joint popped out while a shoulder separation means the AC joint was affected. A MRI showed no extensive structural damage but either way the Titans will likely sit him for a game or two to allow the injury to completely heal.

Rashard Mendenhall: Mendenhall is expected to make his return from surgery to repair a torn anterior cruciate ligament (ACL) in his knee. He's worth a look in most leagues but I would scale back early expectations since the surgery occurred less than 12 months ago.

Laurent Robinson: Robinson is not expected to play after suffering his second concussion in as many weeks. Concussions are cumulative and don't be shocked if this carries over into Week 6 as well.

John Skelton: The same ankle sprain that has sidelined Skelton for three straight weeks also kept him out of Monday's practice. The Cardinals have a short week of preparation as they take on the Rams in the Thursday night game so it seems likely that Kevin Kolb will behind center in Week 5.

Jeff Stotts is a Certified Athletic Trainer, MAT, PES and the Injury Analyst for Rotowire.com. You can follow him on twitter @RotoWireATC.